The vermifoem appendix is a blind-ended worm like structure that out pouches from the ceacum, a part of the large intestine. When is is infected, it gives rise to appendix. The normal appendix, depending on the text one reads from, measures between 2-30cm. Our index case came with classical signs of appendix. Upon operating, we met a mass with the appendix embedded. We carefully removed adhesions until we arrived the appendix and removed it. It was unusually fat, measuring 9cm in length and 2cm in width. The attendant who was helping out had to let her opinion out. "I have never seen it this big before! ". She exclaimed It took us 3hours to reach and remove this "bad girl" here. One of the extension worker helped out and she was amazing standing the whole length through the surgery. He survived only because we had doctors on ground. Doctors work with clinical acumen. His hunting gun had gone off accidentally while hunting around 1am in the mountains. His colleagues rushed him here at about that time. Exams revealed that all his vitals were stable and abdomen wasn't swelling up. We cleaned the wound, tagged, started him on some antibiotics and analgesics. We covered for tetanus an commenced him on fluid. The next day we ordered for investigation including abdominal x-ray. He had no bullets lodged in. Good thing. He will be discharged after 48hrs when we are sure the wound is not infected needing debridement and secondary closure. None of these would have been possible without the rural doctor. The rural doctor initiative will continue to work for the benefit of the rural poor.
Good morning.
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